Recommendations for 2nd BA? Have 375cc saline filled to 375. Have capsular constraction, ugly scars. I want to 1) treat cap contrac, 2) revise scars, 3) make areoli smaller/rounder, 4) improve breast direction (to point straight ahead instead of to 11 & 1 o'clock), 5) improve shape (half-spherical shape with better cleavage and fullness up top than current teardrop/anatomical shape, 6) increase size slightly, 7) replace saline with silicone. Full vs concentric lift? Pocket revision? Mod+ or HP?
Revision for Capsular Contraction, Scars, Nipples, Fullness, Etc? (photo)
Doctor Answers (9)
The more complicated the problem, the more important it is that you find the right surgeon
I don't think that it would be responsible for me to try to advise you without the benefit of a careful review of your history and goals, and a careful examination.
I think that your goals are achievable, but the procedure and its details would probably vary with the surgeon you choose- and this is okay, as long as that surgeon can show you examples of his work that you find pleasing.
Your best bet if your goal is to be safe and happy is to not worry about the how and why, and research the "who". In the hands of a talented and experienced surgeon your chances of being happy will be high and those of needing another revision low.
Laundry List for Breast Augmentation Revision
Not sure that all request can be accomplished. Your pictures are helpful but with all your request it is better that you see several board certified plastic surgeons.
Breast asymmetry and ptosis
You have a very common condition,breast asymmetry and ptosis (sagging)
As you already have saline implants ,I would recommend adjustable saline implants .This will enable you to do post operative adjustments to correct not only volume ,but also shape
A circum-areolar mastopexy may be sufficient . This will reposition your areolae and reduce the size
The adjustable gel implant would be ideal but unfortunately is still not FDA approved in the USA
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Breast implant revision can help with capsular contracture and overall aesthetic breast appearance
Over time, your breast implants can develop capsular contracture (scarring) and the areolae can widen as you have seen. Your requests do seem reasonable enough, and I believe you can get a nice result doing almost exactly as you have suggested. Depending on where your current scars are located, the scars can be revised and the new implants can be placed through the existing incisions. Although, switching to silicone implants may require a slightly larger incision. The areolae can be made smaller with a lift, but you'll most likely need a vertical or lollipop mastopexy (breast lift) to achieve more projection to your breasts. High profile implants are fantastic (Natrelle style 45) to get great projection and improved cleavage. In my experience, these are the implants to get and they give outstanding results! Good luck! Dr. Schreiber, Baltimore Plastic Surgeon
Breast lift with implants
I agree with the other doctors that given your history an exam is needed. You appear to have a scar all the way around your areola wich may be from a prior attemptted breast lift using a donut lift. I would probably use moderate plus profile for your breast diameter. A lolipop lift should do the trick with scar release. Of course it would be nice to see your original pre op pictures and read the operative report from your first surgery. Good luck and please see several board certified plastic surgeons for consultation.
Revisional breast surgery
Revision for Capsular Contraction, Scars, Nipples, Fullness, Etc?
Thanks for the very good series of posted photos. I would have liked to see a before photo to compare the results. In my view you are requesting quite a few changes and a hope of improvement. Think the capsule repair and external areolar revision make good sense. As for a full lift I would offer that as a second stage in the operative plan. But ONLY in person examination/consult will help, seek this please. Regards
Capsulectomy, pocket correction, implant exchange, and circumvertical (lollipop) breast lift
The changes that you will want to achieve require separate steps. The capsule contracture would best be treated by capsule removal (capsulectomy), the implants chosen as needed, the scars will be corrected with the breast lift, the breast shaping procedure that would likely be best is a circumvertical breast lift (lollipop). There is a good chance that you will also need pocket tightening at the lower portion of your breasts (capsulloraphy) I have attached a link of a before and after photos from my website that had most of the above.
All the best,
Dr Remus Repta